Real-Time CGM Reduces Risk of Large Newborns in Gestational Diabetes: Daily Dose

Patient Care brings primary care clinicians a lot of medical news every day—it’s easy to miss an important study. The Daily Dose provides a concise summary of one of the website's leading stories you may not have seen.

On September 12, 2025, we reported on findings from a study presented at the 61st annual meeting of the European Association for the Study of Diabetes that was designed to address the lack of sufficiently powered randomized controlled trials evaluating real-time continuous glucose monitoring (rt-CGM) in women with gestational diabetes mellitus (GDM).

The study

The open-label, international trial was conducted across multiple European centers. Investigators enrolled 375 women with GDM, who were randomly assigned to either SMBG (n=185) or rt-CGM (n=190). The primary outcome was the proportion of LGA infants. Secondary endpoints included requirement for glucose-lowering medication and glucose metrics derived from CGM. Women in the SMBG group used a blinded CGM device for 10 days after randomization and again between 36–38 weeks of gestation, while the rt-CGM group used the devices continuously until delivery. After accounting for dropouts, 170 women in the rt-CGM group and 175 in the SMBG group were included in the primary endpoint analysis.

The findings

The proportion of LGA newborns was significantly lower among women using rt-CGM compared with SMBG (3.5% vs 10.3%; P=.014). Newborn weight percentiles were also lower in the rt-CGM group.

Women using rt-CGM demonstrated improved time in tight range (65–140 mg/dL) between 36 and 38 weeks of gestation, particularly among those prescribed glucose-lowering medications. Although the total amount of glucose-lowering medication did not differ between groups, rapid-acting insulin was prescribed more frequently in the rt-CGM group than in the SMBG group (41.2% vs 30.3%; P=.035).

Authors' comments

"Rt-CGM outperforms SMBG in reducing the risk of LGA offspring. Glycemic control improves modestly in rt-CGM users, who also require more rapid acting insulin. Consequently, rt-CGM should be offered as standard care for women with GDM."

Click here for more details.